CATASTROPHIC SPORTS INJURY RESEARCH THIRTY-FOURTH ANNUAL …€¦ · 05/10/2017 · THIRTY-FOURTH ANNUAL REPORT FALL 1982 - SPRING 2016 From the National Center for Catastrophic

CATASTROPHIC

SPORTS INJURY RESEARCH

THIRTY-FOURTH ANNUAL REPORT

FALL 1982 - SPRING 2016

From the

National Center for Catastrophic Sport Injury Research

At The University of North Carolina at Chapel Hill

Website: nccsir.unc.edu

Prepared by:

Kristen L. Kucera, MSPH, Ph.D., ATC

Leah Cox Thomas, MS, CRC, LRT/CTRS

University of North Carolina

Chapel Hill, NC 27514

Robert C. Cantu, MD

Medical Director, National Center for Catastrophic Sport Injury Research

Emerson Hospital

Concord, MA 01742

FINAL

October 5, 2017

DO NOT DISTRIBUTE

Report #: 2017-02

NCCSIR All Sport Report 1982/83-2015/16 ii

Acknowledgements:

We acknowledge the significant contributions of recently retired Frederick O. Mueller, Ph.D.

who directed The National Center for Catastrophic Sport Injury Research (NCCSIR) from 1982

to 2013. Dr. Mueller’s work over the past 30 years has improved the safety of football for the

participants and these impacts are demonstrated in the pages of this football report.

We also acknowledge NCCSIR staff members Leah Cox Thomas, Catherine Wolff, Rebecca

Yau, Hannah Price, and Sue Wolf, and members of the Consortium for Catastrophic Sport Injury

Monitoring: Drs. Douglas Casa, Jonathan Drezner, Kevin Guskiewicz, Johna Register-Mihalik,

Steve Marshall, Dawn Comstock, David Klossner, Tom Dompier, Zack Kerr, and Christine

Collins.

We also thank all the athletes, families, coaches, athletic trainers, medical providers, school staff,

state associations, researchers, journalists, and others who have participated in this research and

have shared information with the NCCSIR.

Funding & Disclosures:

The National Center for Catastrophic Sport Injury Research is supported by the American

Football Coaches Association (AFCA), the National Collegiate Athletic Association (NCAA),

the National Federation of State High School Associations (NFHS), the National Athletic

Trainers’ Association (NATA), the American Medical Society for Sports Medicine (AMSSM),

the National Operating Committee on Standards for Athletic Equipment (NOCSAE), and The

University of North Carolina at Chapel Hill (UNC-CH).

All rights reserved. This material may not be published, broadcast, rewritten or

redistributed in whole or part without express written permission. Contact the

National Center for Catastrophic Sport Injury Research for all questions

regarding this report at [email protected].

mailto:[email protected]

NCCSIR All Sport Report 1982/83-2015/16 iii

TABLE OF CONTENTS

Page

Introduction 1

Methods

Outcome Definitions 2

Data Collection 2

Participation Data 3

Analysis 4

Results

Current year summary – AY2015-2016 4

Overall summary 5

Discussion 6

Recommendations 8

Case Summaries for AY2015-2016 12

References 26

NCCSIR All Sport Report 1982/83-2015/16 iv

LIST OF TABLES

Page

Table 1: Number of All catastrophic injuries/illnesses by year: All sports

combined, all levels (high school and college)

27

Table 2: Number of Direct catastrophic injuries/illnesses by year: All sports

combined, all levels (high school and college)

28

Table 3: Number of Indirect catastrophic injuries/illnesses by year: All

sports combined, all levels (highs school and college)

29

Table 4a: Number of Direct catastrophic injuries/illnesses by severity by

sport: High school all years combined

30

Table 4b: Number of Indirect catastrophic injuries/illnesses by severity by

sport: High school all years combined

31

Table 5a: Number of Direct catastrophic injuries/illnesses by severity by

sport: College all years combined

32

Table 5b: Number of Indirect catastrophic injuries/illnesses by severity by

sport: College all years combined

33

Table 6a: Number of Catastrophic injuries/illnesses by Severity by year:

High school

34

Table 6b: Number of Catastrophic injuries/illnesses by Severity by year:

College

35

Table 7a: Rate of direct catastrophic injuries/illnesses by severity by year:

High school

36

Table 7b: Rate of direct catastrophic injuries/illnesses by severity by year:

College

37

Table 8a: Rate of indirect catastrophic injuries/illnesses by severity by year:

High School

38

Table 8b: Rate of indirect catastrophic injuries/illnesses by severity by year:

College

39

Table 9a: Rate of Direct catastrophic injuries/illnesses by level and severity

by sport: High school

40

Table 9b: Rate of Direct catastrophic injuries/illnesses by level and severity

by sport: College

41

NCCSIR All Sport Report 1982/83-2015/16 v

Table 10a: Rate of Indirect catastrophic injuries/illnesses by level and

severity by sport: High school

42

Table 10b: Rate of Indirect catastrophic injuries/illnesses by level and

severity by sport: College

43

Table 11: Characteristics of all catastrophic injuries/illnesses AY 2015/16 44

Table 12: Participation numbers, 1982-1983 to 2015-2016

46

Note: Tables I-IX are located in a separate Appendix document located

here: http://nccsir.unc.edu/reports/.

LIST OF FIGURES

Page

Figure 1: Rates of fatal catastrophic direct and indirect injuries/illnesses by

sport-gender among high school participants, 1982/83-2015/16

47

Figure 2: Rates of all catastrophic direct and indirect injuries/illnesses by

sport-gender among high school participants, 1982/83-2015/16

48

Figure 3: Rates of fatal catastrophic direct and indirect injuries/illnesses by

sport-gender among Collegiate participants, 1982/83-2015/16

49

Figure 4: Rates of all catastrophic direct and indirect injuries/illnesses by

sport-gender among Collegiate participants, 1982/83-2015/16

50

NCCSIR All Sport Report 1982/83-2015/16 1

INTRODUCTION

In 1931, the American Football Coaches Association (AFCA) initiated the First Annual

Survey of Football Fatalities and this research has been conducted at the University of North

Carolina at Chapel Hill since 1965. In 1977, the National Collegiate Athletic Association

(NCAA) initiated a National Survey of Catastrophic Football Injuries, which is also conducted at

the University of North Carolina. As a result of these research projects important contributions

to the sport of football have been made. Most notable have been the 1976 rule changes making it

illegal to make initial contact with the head and face while blocking and tackling, the National

Operating Committee on Standards for Athletic Equipment (NOCSAE) football helmet standard,

improved medical care for the participants, and better coaching techniques.

Due to the success of these two football projects the research was expanded to all sports

for both men and women, and a National Center for Catastrophic Sports Injury Research

(NCCSIR) was established in 1982. The decision to expand this research was based on the

following factors:

1. Research based on reliable data is essential if progress is to be made in sports safety.

2. The paucity of information on injuries in all sports.

3. The rapid expansion and lack of injury information in women's sports.

In 1987, a joint endeavor was initiated with the Section on Sports Medicine of the

American Association of Neurological Surgeons. The purpose of this collaboration was to

enhance the collection of medical data. Dr. Robert C. Cantu, Chairman, Department of Surgery

and Chief, Neurosurgery Service, Emerson Hospital, in Concord, MA, is the Medical Director of

the NCCSIR and has been responsible for evaluating the medical data. Dr. Cantu is also a Past-

President of the American College of Sports Medicine. The NCCSIR has been directed for the

past 30 years by Dr. Frederick Mueller. Dr. Mueller retired in the Spring of 2013 and the

NCCSIR continues under new direction (Dr. Kucera). The NCCSIR has expanded to become a

consortium of universities (University of North Carolina, Boston University, University of

Washington, University of Connecticut, University of Colorado, University of Maryland) with

expertise in head/neck, cardiac, and heat-related sports medicine (these three areas account for

the overwhelming majority of catastrophic events).


To learn more about NCCSIR please visit: http://nccsir.unc.edu/about/

To learn more about the Consortium please visit: http://nccsir.unc.edu/consortia-and-partners/

To access online reports please visit: http://nccsir.unc.edu/reports/

METHODS

Outcome Definitions

For the purpose of this research the term catastrophic is defined as any severe injury

incurred during participation in a school/college sponsored sport. Catastrophic is divided into

the following three definitions:

1. Fatality

2. Non-Fatal - permanent severe functional disability.

3. Serious - no permanent functional disability but severe injury. An example would be

fractured cervical vertebra with no paralysis.

Sports injuries are also considered traumatic (or direct) or exertional/systemic (or

indirect). The definition for direct and indirect is as follows:

Direct - Those injuries that resulted directly from participation in the skills of the sport.

Indirect - Those injuries that were caused by systemic failure as a result of exertion

while participating in a sport activity or by a complication that was secondary

to a non-fatal injury.

Note: Beginning in 2014, NCCSIR also collects non sport-related injuries such as sudden

cardiac arrest that occurred outside of sport activity (e.g., during sleep). These events were not

included in the tables, but are described in the Case Summary sections.

Data Collection

Data were compiled with the assistance of coaches, athletic trainers, athletic directors,

executive officers of state and national athletic organizations, online news reports, and

professional associates of the researchers. Data collection would not have been possible without

the support of the NCAA, the National Federation of State High School Associations (NFHS),


and the AFCA. Upon receiving information concerning a possible catastrophic sports injury,

contact by telephone, email or personal letter and questionnaire was initiated with the injured

player's athletic trainer, athletic director, or coach. Data collected included background

information on the athlete (age, height, weight, experience, previous injury, etc.), accident

information, immediate and post-accident medical care, type injury, and equipment involved.

Autopsy reports are used when available. In order to improve overall capture of catastrophic

sport injury and illness events, NCCSIR and the Consortium for Catastrophic Injury Monitoring

in Sport developed an online portal where anyone can report a catastrophic event:

https:\\www.sportinjuryreport.org. The portal was activated in January 2015.

Participation in Sport

Yearly participation estimates for high school athletes are obtained from NFHS

participation reports (available online:

https://www.nfhs.org/ParticipationStatistics/ParticipationStatistics/). NFHS high school annual

athletic participation for 2015/16 included approximately 7,866,265 athletes (4,541,959 males

and 3,324,306 females). Yearly participation estimates for collegiate level athletes are obtained

from the National Collegiate Athletic Association (NCAA) participation reports (accessed

online: https://www.ncaapublications.com/p-4445-2015-16-ncaa-sports-sponsorship-and-

participation-rates-report.aspx). NCAA participation for 2015/16 in championship sports was

486,859 athletes. There were 274,973 males and 211,886 females. There were also 3,472 males

in non-championship sports (archery, badminton, bowling, equestrian, rowing, rugby, sailing,

and squash) and 2,200 females participating in emerging sports (archery, badminton, equestrian,

rugby, sand volleyball, squash, synchronized swimming, and team handball).

During the entire 34 year period from the fall of 1982 through the spring of 2016, there

were 213,265,466 high school participant-seasons in the sports covered by this report and

approximately 12,306,124 college participant-seasons (Table 12).

Not all high schools and colleges are members of the NFHS and NCAA. Complete data

is not available for the non-member schools. Therefore, these participation numbers

underestimate the total number of high school and collegiate participants in the United States.


Analysis

Frequencies and incidence rates of catastrophic injury per 100,000 participants were

calculated over the entire 34-year period and stratified by level (high school and college) and

sport. Incidence rates were stratified by direct versus indirect and by severity. Precision of

incident rate estimates expressed by 95% confidence intervals are included in appendix tables.

Note: if there were no events in the sport for a particular year, the year is excluded from

the frequency Table. Rates with number of incidents less than 5 should be interpreted with

caution.

It is important to note that information is continually being updated due to the fact that

catastrophic injury information may not always reach the NCCSIR in time to be included in the

current final report. The report includes data that is reported to the NCCSIR by the NCAA, the

NFHS, online reports, colleagues, coaches, and athletic trainers. There may be additional

catastrophic injuries that are not reported to the NCCSIR. The authors acknowledge that not

every catastrophic injury is included in this report.

RESULTS

Current AY2015-2016 Summary

From July 1, 2015 to June 30, 2016 there were a total of 112 catastrophic injuries/illnesses

captured by NCCSIR among high school and college organized sport participants. Of these, 101

events were due to or occurred during sport-related activities (Table 11). There were also 11

catastrophic events that occurred during non-sport related activity. All were cardiac-related and

are described in the Case Summaries.

Sport-related events: The majority of the sport-related catastrophic events (n=101) were at the

high school level (81%, n=82). Member institutions for collegiate cases included NCAA,

National Association of Intercollegiate Athletics (NAIA), and National Junior College Athletic

Association (NJCAA). Overall 27.7% of cases were fatal, 18.8% were nonfatal, and 53.5% were

serious with recovery. Sixty percent (n=61) were due to direct (traumatic injury) causes and over

half occurred in competition (59.4%) followed by practice (29.7%). The majority of events

occurred to athletes participating in the following sports: football (64.4%), basketball (5.9%),


soccer (5%), track and field (5%), baseball (4%) and swimming (4%). Areas of the body most

commonly effected were heart (30.7%), neck/cervical spine (30.7%), and head/brain (20.8%).

Fractures (24.6%) were the most common types of events followed by sudden cardiac arrest

(11.9%) and other cardiac conditions (11.9%), brain trauma (15.9%), and heat-related illness

(6.9%).

Direct events: 14.8% of direct events were fatal, 31.1% non-fatal, and 54.1% serious with

recovery. A greater proportion of direct events occurred in competition versus practice (80.3%

versus 14.8%). The majority were to the cervical spine (50.8%) and head/brain (31.1%) followed

by the heart (including commotio cordis), lumbar/thoracic spine, and eye (4.9% each). The

majority occurred in football (83.6%).

Indirect events: 47.5% of indirect events were fatal and 52.5% were serious with recovery. A

greater proportion of indirect events occurred in practice versus competition (52.5% versus

27.5%) and 12.5% occurred during conditioning and weight training sessions. The majority

were cardiac-related (60%) and heat/exertional related (22.5%). Football (35%), basketball

(15%), and soccer (12.5%) comprised the majority, followed by track and field (7.5%),

swimming (7.5%), baseball (5%), cross country (5%), and volleyball (5%).

Overall Summary

During this 34-year period, there were 2,477 catastrophic sport-related injuries/illnesses at high

school and college levels (Table 1 – excluding cheerleading, drill team, and rodeo there were

2,359). The majority were non-fatal (62%) and from traumatic or direct mechanisms (67%), and

among high school participants (80%). The proportion of fatal (39% versus 35%) and direct

(67% versus 65%) were not different by high school compared to college level.

The 101 sport-related catastrophic injuries and conditions captured in 2015/16 represents a 20%

increase from the previous year and the highest number of catastrophic events captured since

2009/10 when 102 events were captured. The increase was a results of a higher number of

traumatic brain and cervical spine/spinal cord injuries in 2015/16. Note: see limitations

regarding the interpretation of this percentage increase.


Direct by sport: For high school sports, football had the highest number of direct catastrophic

events, followed by female cheerleading, baseball, wrestling, and male track and field (Table 4a).

Accounting for the number of participants in the sport, cheerleading, male gymnastics, football,

and ice hockey had the highest rates per 100,000 participants (Figure 2, Table 9a). Similar

results were observed when restricted to fatal events (Figure 1).

For college sports, football had the highest number of direct catastrophic events, followed by

female cheerleading, baseball, and male track and field (Table 5a). Accounting for the number

of participants in the sport, male gymnastics, female skiing, football, ice hockey, equestrian and

male gymnastics had the highest rates per 100,000 participants (Figure 4, Table 9b). Similar

results were observed when restricted to fatal events (Figure 3).

Indirect by sport: For high school sports, football had the highest number of indirect catastrophic

events, followed by male basketball, male track and field, wrestling, male soccer, male cross

country, and baseball (Table 4b). Accounting for the number of participants in the sport,

wrestling, football, male basketball, male lacrosse, male water polo, and female cheer had the

highest rates per 100,000 participants (Figure 2, Table 10a). Similar results were observed when

restricted to fatal events (Figure 1).

For college sports, football had the highest number of indirect catastrophic events, followed by

male basketball, female basketball, male soccer, male swimming and wrestling (Table 5b).

Accounting for the number of participants in the sport, male basketball, male water polo, male

wrestling, football, and male rowing had the highest rates per 100,000 participants (Figure 4,

Table 10b). Similar results were observed when restricted to fatal events (Figure 3).

DISCUSSION

The following strengths and limitations should be noted:

Data have been collected by The National Center for Catastrophic Sport Injury Research

for all high school and college sports since 1982 using consistent definitions and


methodology over a 30+ year period. These data are provided annually to sport

organizations (NCAA, NFHS, AFCA), researchers and the public. Sports Medicine

Advisory Committees, Sport Rules Committees, and Coaching committees review the

reports and have used these data to inform and evaluate safety recommendations, medical

care, and rule changes.

Catastrophic events are primarily captured through publicly available media reports.

Therefore, not all catastrophic events are captured. Particularly, for non-fatal

catastrophic events, which may not be reported in the media as comprehensively as

fatalities. Under-reporting may also be due to outcome definitions used (e.g. timing of

the event) and event locations (e.g. at home, personal conditioning). In order to

improve overall capture of these events, NCCSIR and the Consortium for

Catastrophic Injury Monitoring in Sport have developed an online portal where

anyone can report a catastrophic event: https:\\www.sportinjuryreport.org. The

online portal was activated in January 2015. Any observed changes in annual

number of events may be attributed to these described improvements in data

collection methods.

Details surrounding catastrophic events that are only captured through publicly available

media reports may not be completely accurate in the absence of the actual autopsy or

medical reports.

Incidence rates were calculated using participation estimates from NFHS and the NCAA

in the rate denominator (Table 12). These participation estimates do not include schools

that are not members of these two associations. Participation data was not available for

these non-member schools. At present NFHS and NCAA are the only estimates

available. Therefore, the participation numbers (rate denominator) in this report are

underestimated, which results in an overestimate of the actual incidence rate.

It is important to note that catastrophic events are rare and statistical power for some

strata comparisons are limited. Rates with number of incidents less than 5 should be

interpreted with caution.


RECOMMENDATIONS

1. Each athlete should have a complete physical examination with a medical history and an

annual health history update.

2. All personnel involved with training athletes should emphasize proper, gradual, and sport-

specific physical conditioning.

3. Every school should strive to have a certified athletic trainer.

4. Each school should have a written emergency action plan (EAP) in place, all personnel

should have copies, and procedures should be reviewed and practiced annually.

The CDC has guidelines and templates for these plans

(http://www.cdc.gov/niosh/docs/2004-101/emrgact/emrgact1.html).

NCAA and the NFHS have guidelines for these plans at the following websites:

www.nfhs.org and www.ncaa.org.

An automatic electronic defibrillator (AED) should be available and accessible

onsite and staff should be trained in the use.

5. There should be an emphasis on employing well trained athletic personnel, providing

excellent facilities, and securing the safest and best equipment available.

6. There should be strict enforcement of game rules and administrative regulations to protect

the health of the athlete and reduce the risk of catastrophic injury. Coaches and school

officials must support the game officials in their rulings during the sporting event.

7. Coaches should be educated on and have the ability to teach the proper fundamental skills

of the specific sport. Specific to football, the proper fundamentals of blocking and

tackling should be emphasized to help reduce head and neck injuries, especially with

keeping the head out of blocking and tackling.

8. Weight loss in wrestling to make weight for a match can be dangerous and cause serious

injury or death. Coaches should be aware of safety precautions and rules associated with

this practice.

9. There should be continued surveillance and safety research in athletics (rules, facilities,

equipment, medical care and procedures).

10. Sudden cardiac arrest: The number of indirect cardiac related events has increased

over the years and it is recommended that schools have and emergency action plan and

http://www.nfhs.org/

http://www.ncaa.org/


automated external defibrillators (AED) available and accessible on-site for emergency

situations. Early detection and defibrillation is critical for survival (3-5 minutes

recommended). (Casa et al. 2012)

See also Drezner et al. 2007 for additional information about sudden cardiac arrest

preparedness and management: http://www.nata.org/sites/default/files/sudden-

cardiac-arrest-consensus-statement.pdf

11. Heat-illness: All personnel associated with sport participation should be cognizant of the

safety measures related to physical activity in hot weather. Heat stroke and heat

exhaustion are prevented by careful control of various factors in the conditioning program

of the athlete.

The NATA has a heat illness position statement on their web site

(https://www.nata.org/news-publications/pressroom/statements/position) with

recommendations for prevention: Casa et al. 2015

(http://natajournals.org/doi/pdf/10.4085/1062-6050-50.9.07?code=nata-site) and Casa

& Cisllan, 2009 (http://natajournals.org/doi/pdf/10.4085/1062-6050-44.3.332)

Coaches, athletic trainers, and players should refer to the multiple published best

practices by the NATA, American College of Sports Medicine (ACSM), NFHS, and

NCAA on preventing and managing heat illness. Emergency action plans should be

activated.

Link to the NFHS Sport Medicine Advisory Committee Position Statements:

https://www.nfhs.org/sports-resource-content/nfhs-sports-medicine-position-

statements-and-guidelines/

Link to handout from the NATA on Heat Illness:

http://www.nfhs.org/media/1015650/2015-nata-heat-illness-handout.pdf

Link to handout from the Kory Stringer Institute on heat illness:

http://ksi.uconn.edu/wp-content/uploads/sites/1222/2015/03/Preventing-Surviving-

EHS.pdf

12. Head Trauma: When a player has shown signs or symptoms of head trauma (such as a

change in the athlete’s behavior, thinking, or physical functioning), the player should

receive immediate medical attention from an appropriate medical provider and should not


be allowed to return to practice or game that day. The athlete should not be allowed to

return to practice or game without an evaluation by an appropriate medical provider.

All athletes and athletic personnel should follow the state, NFHS, and NCAA policies

related to concussion and return to play. See the following CDC resource for a list of

states with concussion policies: https://www.cdc.gov/headsup/policy/index.html

For the most up to date information on concussion management please see the

updated Consensus Statement on Concussion in Sport: The 5th International

Conference on Concussion in Sport held in Berlin, October 2016 (McCrory et al.

2017 available at http://bjsm.bmj.com/content/51/11/838).

Some cases associated with brain trauma reported that players complained of

symptoms or had a previous concussion prior to their deaths. The team physician,

athletic trainer, or coach should ensure players understand signs and symptoms of

concussion and brain trauma. Players should also be encouraged to inform the team

physician, athletic trainer, or coach if they are experiencing any of the signs or

symptoms of brain trauma outlined by the CDC.

HEADS UP ON CONCUSSION IN SPORTS:

Information for Parents, Coaches, and School & Sports Professionals. Available at:

http://www.cdc.gov/headsup/highschoolsports/index.html

The NFHS Sport Medicine Advisory Committee has developed guidelines for concussion

management in sports: http://www.nfhs.org/media/1014737/suggested-guidelines-for-

management-of-a-concussion-in-sports-october-2013-2.pdf

The NCAA has created several rules to help manage concussion injuries. The NCAA has

created a set of best practices that are available in the Sports Medicine Handbook which may

be found at: http://www.ncaapublications.com/

Every NCAA member school is required to have a concussion-management plan that:

Requires student-athletes to receive information about the signs and symptoms of

concussions. They also are required to sign a waiver that says they are responsible for

reporting injuries to the medical staff.

Mandates that institutions provide a process for removing a student-athlete from

play/participation if they exhibit signs of a concussion. Student-athletes exhibiting


signs of a concussions must be evaluated by a medical staff member with experience

in the evaluation and management of concussions before they return to play.

Prohibits a student-athlete with concussion symptoms from returning to play on the

same day of the activity.

Requires student-athletes diagnosed with a concussion be cleared by a physician

before they are permitted to return.

13. Spinal injuries: Updated guidelines for the care of the spinal cord injured athlete can be

found at the NATA’s website: http://www.nata.org/sites/default/files/Executive-

Summary-Spine-Injury-updated.pdf. The final guidelines “Appropriate Prehospital

Management of the Spine-Injured Athlete” will be published in the Journal of Athletic

Training when completed.

See also Swartz et al. 2009 for information about cervical spinal injury management

and prevention:

http://www.nata.org/sites/default/files/AcuteMgmtOfCervicalSpineInjuredAthlete.pdf


CASE SUMMARIES AY2015/16

*Compiled from available media reports (n=112 events captured by NCCSIR).

COLLEGE/UNIVERSITY

College/University Baseball Direct

A male 22 year old college baseball pitcher was sitting in the dugout during a game when a foul

ball was batted at him. It struck him on his temple. He was transported to the hospital. No other

information is known.

College/University Baseball Indirect

A male 19 year old collegiate sophomore baseball player collapsed during a game while he was

in his native country and died. Cause of death is unknown but is suspected to be cardiac related.

College/University Baseball Not sport-related

A male 19 year old college freshman baseball player died in his sleep. Cause of death was due to

heart failure from cardiomyopathy. He has been diagnosed a month earlier and was not wearing

his defibrillator vest.

A male 21 year old college junior baseball player collapsed at a friends house after practice. CPR

was administered before EMS arrived. He was diagnosed with Wolff Parkinson White

Syndrome. A full recovery is expected.

College/University Basketball Not sport-related

A male 20 year old college junior basketball center collapsed at home. CPR was administered by

first responders before he was transported to the hospital. Cause of death is suspected to be

related to an enlarged heart.

College/University Football Direct

A 23 year old male college sophomore football linebacker was trying to make a tackle during

practice when he injured his neck. He was attended to by athletic trainers before being

transported to the hospital. He was diagnosed with a fractured neck and a slipped disc. He

underwent surgery and a full recovery is expected.

A male college junior football linebacker collided with another player during the 1st quarter of a

game. He was transported to the hospital where he was diagnosed with five fractured vertebrae.

He underwent surgery and is slowly regaining feeling. He was transferred to a rehabilitation

facility and is paralyzed from the waist down.

A male college junior football wide receiver jumped into the air to catch a pass during the first

game of the season. After catching the ball, he crashed into the goalpost. His body went numb


and he was immediately attended to by athletic trainers. He was transported to the hospital where

he was diagnosed with a fractured bone in his neck. He wore a neck brace and was out for the

season. A full recovery is expected.

A male college redshirt freshman football cornerback sustained a neck injury during a game. He

was diagnosed with fractured vertebrae. A full recovery is expected but he is out for the season.

A male college freshman football free safety collided with a teammate during football practice.

He fell to the ground and was unconscious and unable to move. He was immediately attended to

by athletic trainers before being transported to the hospital. He was diagnosed with a fractured

C1 and C2 vertebrae. He underwent surgery and was placed in a halo brace. He has regained

feeling and movement in all extremities. He is expected to have a long but full recovery.

A male college sophomore football linebacker sustained a neck injury during practice from a

head to head collision. He was transported to the hospital but released the following day with a

neck brace. A full recovery is expected.

A male college junior football quarterback sustained a neck injury during a game. He was carted

off the field with numbness in his hands. No serious damage was found. A full recovery is

expected.

A male college sophomore football wide receiver was attempting to make a block in the 3rd

quarter of a game. He did not get up after the play and was immediately attended to by athletic

trainers before being transported to the hospital. He underwent surgery on his neck/spine and has

regained movement in his upper body. Long term prognosis is unknown.

A male 21 year old college junior quarterback injured his neck during the 4th quarter of a game.

He was diagnosed with fractured cervical vertebrae and surgery was recommended. A full

recovery is expected.

A male 19 year old college freshman running back was grabbed by his facemask during a game

in the 3rd quarter. He was taken off the field on a backboard and transported to the hospital. He

underwent surgery on his neck and was released from the hospital two days later. No other

information was released but a full recovery is expected.

A male 21 year old college sophomore football offensive lineman was blocking on a field goal

attempt during a game when he sustained a neck injury. He was carted off the field and

diagnosed with a spinal cord contusion. A full recovery is expected.

A male 21 year old college junior football offensive tackle was participating in a conditioning

session when he was hit in the eye with a stretch band. He was taken to the hospital but the

injury resulted in vision loss.

College/University Football Indirect


A male 20 year old college sophomore football defensive end had a medical emergency during a

team conditioning session. He was transported to the hospital. He died a week later. Cause of

death is currently unknown but is suspected to be cardiac related.

College/University Football Not sport-related

A male 20 year old college junior redshirt football player was found unresponsive at his home.

He was pronounced dead at the hospital. Cause of death was due to hypertrophic

cardiomyopathy.

College/University Rodeo Direct

A male 19 year old college freshman rodeo athlete was competing in a bareback bronc riding

event when he was thrown from his horse and trampled. He was attended to by EMS before

being transported to the hospital. He died as a result of his injuries. Cause of death is due to blunt

force chest trauma (commotio cordis).

College/University Soccer Indirect

A female 21 year old college soccer player collapsed during practice. She was immediately

attended to by an athletic trainer and support staff, who administered CPR. She was transported

to the hospital where she was diagnosed with right ventricular dysplasia. She underwent surgery

to have a defibrillator implanted. A full recovery is expected.

College/University Track and Field Direct

A male college senior track and field pole vaulter sustained an injury during a tournament. He

was diagnosed with a fractured orbital bone and bruising to his brain. He is scheduled to undergo

surgery and a full recovery is expected. No other details are available.

College/University Volleyball Indirect

A female 20 year old college sophomore collapsed in the locker room during a volleyball game.

She had complained of a severe headache and blurred vision. She was transported to the hospital

by her parents and rushed into surgery. Cause of collapsed was due to arteriovenous

malformation (AVM). A long but full recovery is expected.

HIGH SCHOOL

High School Baseball Direct

A male 17 year old high school baseball player was bunting during a summer league game when

he was struck in the chest by the ball, which caused his heart to stop. He was immediately


attended to by bystanders who began CPR. An AED was used to revive him. He was transported

to the hospital and a full recovery is expected.

High School Baseball Indirect

A male 14 year old high school freshman baseball player was participating in an afternoon

practice when he told the coach he wasn't feeling well (complained of stomach hurting). He was

seen by the school nurse before an ambulance took him to the hospital. He passed away two days

later. Cause of death was due to rhabdomyolysis associated with sickle cell trait.

High School Basketball Indirect

A male 17 year old high school senior basketball player was lifting weights with his team and

collapsed during the following personal conditioning run. Attempts to resuscitate him were

unsuccessful. Cause of death is due to sudden cardiac arrest.

A female 14 year old high school freshman basketball player had just completed a track run in

practice when she collapsed. She was treated by EMS before being transferred to the hospital

where she later died. Cause of death is due to thoracic aorta dissection.

A male 16 year old high school junior basketball player collapsed during practice while going

through drills. He was immediately attended to by coaches and first responders until EMS

arrived. He was airlifted to the hospital where he went into cardiac arrest multiple times before

passing away five days later. Cause of death is unknown but is suspected to be cardiac related.

A male high school freshman basketball player collapsed at half court during the second quarter

of the game. He was immediately attended to by coaches and the opposing team's athletic trainer.

CPR was started and AED applied within minutes while EMS were called. One shock was

administered before EMS arrived. He was transported to the hospital. Cause of collapse is

thought to be cardiac in origin. A full recovery is expected.

A male high school junior basketball guard had just finished practice when he collapsed.

Coaches immediately began CPR and called 911. EMS arrived within minutes and an onsite

AED was administered. He was transported to the hospital where he is recovering. He was

diagnosed with an enlarged heart. A full recovery is expected.

A male 19 year old high school senior collapsed while playing pickup basketball. He later died at

the hospital. Cause of death was due to hypertrophic cardiomyopathy. He was set to play

basketball in college.

High School Basketball Not sport-related

A male 15 year old high school basketball player was found collapsed at his home. He was

transported to the hospital where he later died. Cause of death was due to a congenital heart

defect.


A male high school senior basketball player complained of feeling ill and was experiencing chest

tightness and weakness. His mother took him to the hospital and his heart stopped two days later.

He was revived with CPR and defibrillation. Cause of the illness is currently unknown. A full


A male 18 year old high school senior basketball player was found dead in his room. Cause of

death was due to cardiac dysrhythmia.

High School Cheerleading Direct

A female high school freshman cheerleader was practicing for the state finals when another

teammate's knee hit her head, causing a skull fracture. Unaware of the injury, she finished the

competition. The following day, her parents took her to the hospital where she was diagnosed. A

full recovery is expected.

High School Cross Country Direct

A female 14 year old high school freshman cross country runner was hit by a car during practice.

She died as a result of her injuries.

High School Cross Country Indirect

A female 14 year old high school freshman cross country runner had completed a 3 mile run on

the second day of tryouts when she collapsed. An athletic trainer witnessed the collapse and

EMS were called. Attempts to resuscitate her were unsuccessful. She was transported to the

hospital where she later died. Cause of death was due to congenital heart defect.

A male 15 year old high school cross country runner collapsed during practice. He was attended

to by his coach/athletic director, who began CPR. He was transported to the hospital and

underwent surgery to have a defibrillator implanted. Cause of sudden cardiac arrest is unknown.

A full recovery is expected.

High School Cross Country Not sport-related

A male 15 year old high school cross country athlete collapsed at home from sudden cardiac

arrest. He was revived by EMS with the AED. He was transported to the hospital where he was

diagnosed with Wolff Parkinson White Syndrome. Surgery was scheduled but a full recovery is

expected.

High School Field Hockey Indirect

A female 16 year old high school junior field hockey player collapsed during practice. She died

shortly after at the hospital. Cause of death was due to an arteriovenous malformation. The

family was unaware of any pre-existing conditions.

High School Football Direct


A male 16 year old high school junior cornerback was making a tackle during the third play of a

game when he injured his neck. He was able to walk off the field and continued playing until the

neck pain became severe. His mother took him to the ER where he underwent x-rays and MRI

scans. They revealed a fractured C4 and C5 vertebrae. He underwent surgery but was not

allowed to play football for the rest of the season. A full recovery is expected.

A male 15 year old high school freshman on the junior varsity football team collapsed at the end

of the game. He was airlifted to the hospital where he underwent brain surgery for a subdural

hematoma. He is expected to recover but requires assistance with everyday activities and school.

A male 16 year old high school junior football running back sustained a neck injury during

practice from a tackle. He was reported to have injured three vertebrae in his neck. He is

currently paralyzed.

A male 16 year old high school sophomore junior varsity football running back was involved in a

helmet-to-helmet collision during the opening kickoff of the second half of a game. He was

motionless on the field for 20 minutes before being transported to the hospital. He underwent

neck surgery to have a metal plate placed near his C4 vertebrae. He is currently paralyzed from

the waist down.

A male high school junior football defensive back sustained a neck injury during the last five

minutes of a game. He was taken to the hospital with an unspecified neck injury. He underwent

surgery and is in stable condition. Athlete has movement in one arm but is paralyzed from the

waist down.

A male high school sophomore football defensive and running back sustained a hit during the

2nd quarter of a game. Coaches thought he sustained a concussion but he passed protocols. He

walked off the field and to the locker room at half time when he began to feel tingling. His

family took him to the hospital where he underwent two surgeries to stabilize fractured vertebrae

in his neck. He is expected to fully recover but is not allowed to play football again.

A male 16 year old freshman high school football player was hit by another player during the 4th

quarter punt return. Another teammate reported that he tripped and fell into a blocker which

caused his head to go backwards. He was immediately attended to by EMS and athletic trainers.

He was transported to the hospital but later died. Cause of death is due to a fractured neck.

A male high school junior football player sustained a hard hit during the 2nd quarter of a game.

The athletic trainer assessed him for a concussion shortly before he collapsed. The athletic

trainers and EMS immediately attended to him before he was airlifted to the hospital where he

underwent brain surgery for a traumatic brain injury. He was in the ICU but was alert and

talkative. Long term prognosis is undetermined.

A male high school junior football defensive tackle fractured his neck while making a tackle

during a game. An ambulance transported him to the hospital where scans indicated that he

fractured three vertebrae, two in his neck and one in his upper back. No surgery is required. A



A male high school junior linebacker caught an interception during a game. He was tackled and

sustained a traumatic brain injury. He was immediately attended to by EMS and was transported

to the hospital. He will have a very long but full recovery.

A male 16 year old high school junior football linebacker scored a touchdown during the 4th

quarter of a game. He sustained a head injury during a tackle on the kickoff return. He was

transported to the hospital where he underwent surgery. He was placed in a medical coma but

died a week later. Cause of death is due to subdural hematoma.

A male 16 year old high school football player ran to the sideline, was holding his head, and

collapsed during a game. He was transported to the hospital where he underwent surgery for a

traumatic brain injury. He was in a medically induced coma for a week before being transferred

to a rehab hospital. A long but full recovery is expected.

A male high school senior football defensive lineman was making a routine tackle during a game

when he went limp. He lost feeling in his body but eventually regained it. He walked off the field

and was transported to the hospital. A MRI determined he had damaged the ligaments between

his C1-C2 vertebrae. A full recovery is expected but he is not allowed to play football.

A male high school senior football player collapsed during a game from a severe brain injury that

caused a brain bleed. He underwent surgery to relieve swelling. Reports indicate he had

sustained a hard hit two games prior, complained of a headache, and continued to play. Long

term prognosis is unknown.

A male 14 year old high school freshman football linebacker was pulled out of a game during the

1st quarter by athletic trainers and coaches for a concussion. He was not allowed to return to the

game. He was taken to the ER by his parents that evening for vomiting, balance issues, and

difficulty swallowing. The following night he was taken back to the ER where he was diagnosed

with a stroke. He had suffered a torn blood vessel in his neck that caused a blood clot that

traveled to his brain. He has a lengthy recovery and long term prognosis is unknown.

A male high school senior football tight end sustained a neck injury during kickoff return in the

3rd quarter of a game. He was transported by EMS to the hospital where he was found to have a

C5 vertebrae fracture and sprained ligaments. He is in a neck brace until the ligaments heal. A


A male 18 year old high school senior football long snapper and lineman was covering a punt

when he was blindsided by a hit during a game. He was motionless on the field until EMS

transported him to a helicopter for transfer to the hospital. He was diagnosed with a severed

nerve between his T7 and T8 vertebrae. He is relearning how to walk. Long term prognosis is

unknown.

A male high school senior football defensive back made a hit during a game. He initially thought

he had a concussion but complained of neck pain. He went to the doctor the next day and an X-

ray revealed no damage. He went back a second time and an X-ray revealed a torn C1 ligament.

He underwent surgery to fuse his fractured C2 and C3 vertebrae. A full recovery is expected.


A male 17 year old high school senior football quarterback sustained a hit in the 2nd quarter of a

game. He walked off the field but appeared disoriented. Around halftime he collapsed on the

sidelines. He was transported to the hospital but later died. Cause of death was due to a ruptured

spleen.

A male high school freshman football defensive back and wide receiver sustained a blow to the

head during practice for the freshman team. He collapsed and was unresponsive. He was

immediately attended to by the athletic trainer and coaches before being transported to the

hospital by EMS. He was airlifted to another hospital and underwent brain surgery to alleviate

swelling. Three days post-injury, he was walking with assistance. A long but full recovery is

expected.

A male high school senior football player made a tackle during a game. He went to the sideline

complaining of neck pain. His mother transported him to the hospital where he was diagnosed

with a fractured C1 and C2 vertebrae. He will spend the next three months in a halo brace. A

long but full recovery is expected.

A male high school senior football player injured his neck while making a tackle on a kickoff

return. He was immediately attended to by the athletic trainer. He was transported to the hospital

where CT scans reveled a C6 fracture. He was released home the next day. No surgery is

required and a full recovery is expected.

A male 17 year old high school senior football defensive back was injured while making a tackle

during the 4th quarter of a game. He was transported by ambulance to the hospital where he

underwent emergency brain surgery. He died three days later. Cause of death was due to blunt

force trauma. Reports indicate that he has sustained a concussion about a month prior but was

cleared to return to play.

A male high school junior football (JV) player sustained a blow to the head during a game. He

walked off the field and collapsed on the sideline. He was transported to the hospital where he

underwent brain surgery. He is currently in a medically induced coma. Reports indicate that a

long but full recovery is expected.

A male high school sophomore football linebacker was making a tackle during the 4th quarter of

a game when he fractured his neck. He was transported to the hospital by EMS. He underwent

surgery and is expected to have a full recovery.

A male 16 year old high school junior football wide receiver, quarterback, and safety complained

of dizziness before halftime of a game. He then collapsed. He was airlifted to the hospital where

he later died. Official cause of death was due to subdural hemorrhage.

A male 14 year old high school football player sustained a head injury during a scrimmage game.

He was airlifted to the hospital. Prognosis is unknown and no other information is provided.

A male 17 year old high school senior football player was injured on a kick return play during a

playoff game. He was running, was blocked by an opponent and fell to the ground. He got up,

complained of a headache, and collapsed on the sideline. He was attended to by EMS before


being transported to the hospital. He died the following morning. Cause of death was due to a

blunt force head injury.

A male 16 year old high school junior cornerback and wide receiver took himself out of a game

during the 4th quarter due to headaches. He was attended to by the athletic trainer before being

airlifted to the hospital. He is in critical condition from a head injury. He spent months in a

rehabilitation facility before being sent home. He requires 24/7 care.

A male senior football linebacker was making a tackle during the 1st quarter of a game when he

was injured. He was immediately attended to by athletic trainers before being airlifted to the

hospital. He sustained three fractured vertebrae in his neck and spine. He underwent surgery but

is paralyzed from the chest down.

A male 17 year old high school senior football safety was making a tackle during a game when

he sustained a head injury. He walked off the field and collapsed on the sideline. He was

transported to the hospital where he underwent emergency surgery to stop bleeding and relieve

pressure and swelling in his brain. He was placed in a medically induced coma for a week. Long

term prognosis is unknown.

A male 18 year old high school football linebacker was making a tackle when other players

landed on top of him during a game. He reported feeling a pinch in his neck and saw the athletic

trainer. His parents witnessed the event and onsite EMS directed the parents to take the athlete to

the hospital. He was diagnosed with a fractured neck. A full recovery is expected.

A 17 year old male high school junior football player was making a tackle during a game when

he fractured his third cervical vertebrae in two spots. He was transported to the hospital where he

regained feeling. He was released four days later with a neck brace. A full recovery is expected.

A male high school junior football player was tackled in the 4th quarter of a game after fielding a

punt. He was immediately attended to by athletic trainers, who realized he had sustained a neck

injury. He was log rolled and his helmet was cut off before he was transported to the hospital. He

was diagnosed with a fractured C6 vertebrae. No surgery is required and a full recovery is

expected.

A male 17 year old high school football player had just scored a touchdown during a playoff

game, walked off the field, and collapsed. He was transported by ambulance to the hospital

before being airlifted to another. He was diagnosed with head trauma that cause his brain to

swell. He died the following day.

A male 16 year old high school football linebacker was making a tackle during a game when he

was hit, fell to the ground, and other players landed on top of him. He was unable to move. He

was attended to by paramedics before being transported to the hospital. An MRI revealed no

damage and he regained feeling hours later. A full recovery is expected.

A male high school junior football player sustained a neck injury while making a tackle during

spring practice. He reports that he heard his neck snap and was unable to feel his arms or legs.

He was transported to the hospital and spent time in the ICU. A full recovery is expected.


A male 16 year old high school sophomore quarterback sustained a hit during a scrimmage game

and fractured his C6 vertebrae. He was immediately attended by training staff and EMS before

being transferred to the hospital. He was transferred to a rehabilitation center and longterm

prognosis unknown.

A male 16 year old high school senior football wide receiver was participating in a non-contact

game with his team during a football camp. He went to catch a touchdown pass when his head

collided with spectators on the sideline. He was transported to the hospital where he was in a

medically induced coma. He was released home a few weeks later and a full recovery is

expected.

High School Football Indirect

A male 14 year old high school sophomore football offensive lineman collapsed during football

practice. He was transported to the hospital where he later died due to complications from heat

stroke. His body temperature was reported to have reached 105 degrees.

A male high school football player was at morning football practice when he called his mother

complaining of leg cramps. Once he returned home, he collapsed. He was taken to the hospital

where doctors diagnosed him with severe heat exhaustion and dehydration. The heat index was

reported as 109 at 11:00AM. He is expected to fully recover.

A male 16 year old high school junior football player was at a morning football practice when he

began having difficulty breathing. He was transported to the field house and an ambulance was

called. He later died at the hospital. Cause of death is due to heat stroke and rhabdomyolysis.

Reports indicate that heat index had reached 109° by 11am.

A male 17 year old high school senior football player fell ill during morning practice. He was

taken to the locker room where he was cooled with a cold shower before 911 was called. He was

transported to a local hospital before being airlifted to another hospital. Reports indicate that he

was not feeling well three days prior. He is in the ICU in stable condition. Long term prognosis

is unknown.

A male 14 year old high school freshman was participating in a conditioning session with the

freshman football team. His mother picked him up after the 3 hour practice and noticed he was in

distress. He began having a stroke and foaming at the mouth on the way to the hospital. He spent

weeks in a coma and suffered long term brain damage due to heat related illness. The

temperature was 80 degrees with 62% humidity.

A male 16 year old high school junior football player was finishing up a morning practice when

he collapsed. He was immediately attended to by the athletic trainer. When he arrived at the

hospital, he had a 108 degree body temperature and had lost consciousness. He was diagnosed

with heat stroke that also caused liver and kidney failure. He is in critical condition but is

expected to have a long recovery.

A male 15 year old high school sophomore football defensive tackle passed out at the end of

football practice. EMS was called and he was unresponsive with an accelerated heart rate when


he was transported to the hospital. His body temperature was 106 when he arrived. He spent 14

hours in the ICU but a full recovery is expected.

A male 17 year old high school junior offensive lineman collapsed during practice. He was

immediately attended to by the athletic trainer who began CPR. He was transported by EMS to

the hospital where he died two weeks later. Cause of death is due to pulmonary edema from

hypertensive heart disease.

A male high school football player collapsed on the sidelines during the 4th quarter of a game

after going into cardiac arrest. He was transported to the hospital and placed in a medically

induced coma. Three days later he was breathing on his own and is awaiting surgery for a

congenital heart defect. A full recovery is expected.

A male high school freshman football player collapsed during gym class. He was immediately

attended to by school staff who began CPR until EMS arrived and used AED to revive him. He

was transported to the hospital and placed in a medically induced coma. He was diagnosed with

hypertrophic cardiomyopathy. He underwent surgery to have a defibrillator implanted. A full

recovery is expected although he is not allowed to participate in contact sports.

A male 17 year old high school football player was lifting weights with his team. He walked into

the hallway for a break when he collapsed. He was immediately attended to by an athletic trainer

who began CPR while 911 was called. An AED was used to revive him. He was transported to

the hospital where he is currently undergoing tests. Cause is suspected to be due to sudden

cardiac arrest. A full recovery is expected.

A male 15 year old high school football player collapsed at the end of a preseason practice. He

later died at the hospital. Cause of death is pending autopsy but is suspected to be heat related.

A male 14 year old high school freshman was participating in a voluntary football workout when

he collapsed. He was taken to the hospital where he later died. Cause of death was due to

exertional sickling and rhabdomyolysis.

High School Football Not sport-related

A male 18 year old high school senior football player was found dead at home. Cause of death

was due to hypertrophic cardiomyopathy.

High School Gymnastics Direct

A female 14 year old high school gymnast was warming up for practice on the uneven bars when

she fell and landed on her back. She was transported to the hospital where it was found she had

fractured her T10 vertebrae. She underwent surgery and is expected to recover, but currently is

paralyzed from the waist down.

High School Ice Hockey Indirect


A male 16 year old high school junior varsity ice hockey forward collapsed on the bench in the

middle of a game. He was unresponsive for 5 minutes before being transported to the hospital.

He is undergoing tests and long term prognosis is unknown.

High School Ice Hockey Not sport-related

A male 14 year old high school freshman junior varsity hockey player died in his sleep at home.

He had previously played in a game a few hours earlier. Cause of death was due to cardiac

arrhythmia.

High School Lacrosse Direct

A male 17 year old high school senior lacrosse midfielder sustained a lacrosse ball to the chest

during a game. He picked up the ball and began running before collapsing. He was immediately

attended to by an athletic trainer before bystander medical personnel assisted. While 911 was

called, AED was retrieved. One shock was advised to get athlete's heart back into normal

rhythm. He was taken to the hospital and a full recovery is expected. Cause of collapse is due to

commotio cordis.

High School Soccer Indirect

A male 16 year old high school junior soccer goalie collapsed during the first practice of the

season. Coaches immediately began CPR and EMS was called. He was transported to the

hospital where he later died. Athlete had previous incident during cross country but was

medically cleared for play. Cause of death was due to congenital heart defect.

A male high school soccer player collapsed at the end of the last game during a soccer

tournament. An athletic trainer and athletic director began CPR and called for the AED while

they waited for EMS to arrive. A full recovery is expected.

A female 16 year old high school junior varsity soccer player was playing in a game when she

requested to come out. Coaches realized she was having trouble breathing. The athlete took

several puffs of her inhaler before she collapsed to the ground. An athletic trainer administered

CPR until EMS arrived. She was transported to the hospital where she later died. Cause of death

was due to congenital heart defect.

A male high school sophomore soccer player collapsed during summer practice while running

sprints. CPR was immediately began by one of the coaches while athletic trainer was summoned.

Athletic trainer brought AED and used it to revive athlete. He was transported to the hospital

where he underwent tests. A full recovery is expected. Collapsed suspected to be related to

hypertrophic cardiomyopathy.

High School Softball Not sport-related


A female 16 year old high school junior suffered a cardiac event while at home. She was taken to

the hospital where she died about a week later. Cause of death is suspected to be due to sudden

cardiac arrest caused by irregular heart rhythms as a result of a congenital heart defect.

High School Swimming Direct

A male 15 year old high school swimmer slipped while at practice and hit his head on the bottom

of the pool. He had to be rescued by his coach who immediately began CPR. He was transported

to the hospital where he was diagnosed with a fractured C5 and C6 vertebrae. He spent three

months in a rehabilitation facility. He currently is paralyzed from the waist down and has limited

movement in his upper extremities.

High School Swimming Indirect

A female 16 year old high school junior swimmer collapsed in the pool after swimming the

butterfly during practice. Teammates and the coach pulled her from the pool before the coach

started CPR until EMS arrived. She was transported to the hospital and diagnosed with Long QT

Syndrome. She underwent surgery to have a defibrillator implanted and a full recovery is

expected.

A male 16 year old high school junior swimmer went into sudden cardiac arrest during practice.

He later died at the hospital. Cause of death is due to a congenital heart defect.

A female high school senior swimmer had just finished swimming in a relay race when she did

not resurface after going underwater. She was pulled from the pool. CPR and AED used. She

was transported to the hospital where she underwent surgery to have a defibrillator implanted. A


High School Track and Field Direct

A male 18 year old high school senior was participating in the USA Track and Field meet when

he was warming up for an event. He had thrown the javelin and was retrieving it when he tripped

and fell. The javelin pierced his head through the eye. He was transported to the hospital. A full


High School Track and Field Indirect

A male high school track and field athlete collapsed during track practice. He was immediately

attended to by a coach, who started CPR and had other athletes run to get the athletic trainer and

the AED. One shock was administered before paramedics arrived. He received another shock

before being transported to the hospital. No other information is known at this time.

A male 16 year old high school track and field athlete collapsed during practice. He was

immediately attended to by the athletic trainer who administered CPR and used an AED. He was

transported to the hospital where he underwent numerous tests before being diagnosed with

myocarditis. A full recovery is expected.


A male 15 year old high school freshman track and field runner collapsed after crossing the

finish line during the 3200 meter run of the regional meet. He was immediately attended to by

coaches and bystanders before EMS arrived. He was administered CPR and AED was used. He

was transported to the hospital where he later died. Cause of death is unknown but is suspected

to be cardiac related.

High School Volleyball Indirect

A female 17 year old high school senior volleyball player collapsed on the court during a match.

She was immediately attended to by an athletic trainer and first responders, who started CPR.

She was revived with an AED. She was transported by EMS to the hospital where she was

diagnosed with ventricular fibrillation. A full recovery is expected.

High School Wrestling Indirect

A male 18 year old high school senior 220-pound wrestler complained of shortness of breath

during a tournament before collapsing. He was transported to the hospital where he later died.

Cause of death was due to congenital heart defect.


REFERENCES

Casa, D., & Csillan, D. (2009). Preseason heat-acclimatization guidelines for secondary school

athletics. Journal of Athletic Training, 44(3), 332-333. doi: 10.4085/1062-6050-44.3.332

Casa, D. J., J. K. DeMartini, M. F. Bergeron, D. Csillan, E. R. Eichner, R. M. Lopez, M. S.

Ferrara, K. C. Miller, F. G. O'Connor, M. N. Sawka and S. W. Yeargin (2015). "National

Athletic Trainers' Association position statement: Exertional heat illness." Journal of Athletic

Training 50(9): 986-1000.

Casa, D., Guskiewicz, K., Anderson, S., Courson, R., Heck, J., Jimenez, C., et al. (2012).

National athletic trainers' association position statement: preventing sudden death in sports.

Journal of Athletic Training 47(1), 96-118.

Drezner, J. A., Courson, R. W., Roberts, W. O., Mosesso, V. N., Link, M. S., & Maron, B. J.

(2007). Inter-Association Task Force Recommendations on Emergency Preparedness and

Management of Sudden Cardiac Arrest in High School and College Athletic Programs: A

Consensus Statement. Journal of Athletic Training, 42(1), 143–158.

McCrory, P., W. Meeuwisse, J. Dvořák, M. Aubry, J. Bailes, S. Broglio, et al. (2017).

"Consensus statement on concussion in sport—the 5<sup>th</sup> international conference on

concussion in sport held in Berlin, October 2016." British Journal of Sports Medicine 51(11):

838-847.

Swartz, E. E., Boden, B. P., Courson, R. W., Decoster, L. C., Horodyski, M., Norkus, S. A.,

Rehnberg, R. S., Waninger, K. N. (2009). National Athletic Trainers’ Association Position

Statement: Acute Management of the Cervical Spine–Injured Athlete. Journal of Athletic

Training, 44(3), 306–331.


Table 1: Number of All catastrophic injuries/illnesses by year: All sports combined, all levels (high school and college)

College High school All

N % N % N %

1982-1983 10 16.70% 50 83.30% 60 100.00%

1983-1984 13 21.00% 49 79.00% 62 100.00%

1984-1985 9 17.60% 42 82.40% 51 100.00%

1985-1986 16 28.10% 41 71.90% 57 100.00%

1986-1987 18 25.70% 52 74.30% 70 100.00%

1987-1988 15 17.90% 69 82.10% 84 100.00%

1988-1989 17 23.00% 57 77.00% 74 100.00%

1989-1990 10 13.30% 65 86.70% 75 100.00%

1990-1991 14 23.00% 47 77.00% 61 100.00%

1991-1992 11 23.40% 36 76.60% 47 100.00%

1992-1993 10 16.40% 51 83.60% 61 100.00%

1993-1994 11 17.50% 52 82.50% 63 100.00%

1994-1995 12 24.50% 37 75.50% 49 100.00%

1995-1996 8 15.70% 43 84.30% 51 100.00%

1996-1997 9 13.60% 57 86.40% 66 100.00%

1997-1998 15 20.00% 60 80.00% 75 100.00%

1998-1999 10 12.80% 68 87.20% 78 100.00%

1999-2000 9 12.90% 61 87.10% 70 100.00%

2000-2001 17 24.60% 52 75.40% 69 100.00%

2001-2002 14 17.30% 67 82.70% 81 100.00%

2002-2003 16 25.80% 46 74.20% 62 100.00%

2003-2004 18 24.30% 56 75.70% 74 100.00%

2004-2005 9 13.80% 56 86.20% 65 100.00%

2005-2006 12 21.80% 43 78.20% 55 100.00%

2006-2007 13 17.60% 61 82.40% 74 100.00%

2007-2008 15 18.50% 66 81.50% 81 100.00%

2008-2009 17 15.70% 91 84.30% 108 100.00%

2009-2010 27 28.10% 69 71.90% 96 100.00%

2010-2011 15 20.50% 58 79.50% 73 100.00%

2011-2012 15 19.50% 62 80.50% 77 100.00%

2012-2013 12 30.00% 28 70.00% 40 100.00%

2013-2014 16 22.50% 55 77.50% 71 100.00%

2014-2015 17 21.30% 63 78.80% 80 100.00%

2015-2016 18 18.20% 81 81.80% 99 100.00%

Total 468 24.75% 1891 80.16% 2359 100.00%

Total* 503 25.48% 1974 79.69% 2477 100.00%

*Includes Cheerleading, Drill Team, Rodeo


Table 2: Number of Direct catastrophic injuries/illnesses by year: All sports combined, all levels (high school and college)


N % N % N %

1982-1983 4 10.30% 35 89.70% 39 100.00%

1983-1984 8 19.00% 34 81.00% 42 100.00%

1984-1985 9 22.50% 31 77.50% 40 100.00%

1985-1986 15 30.60% 34 69.40% 49 100.00%

1986-1987 14 26.90% 38 73.10% 52 100.00%

1987-1988 8 12.30% 57 87.70% 65 100.00%

1988-1989 13 22.80% 44 77.20% 57 100.00%

1989-1990 8 14.80% 46 85.20% 54 100.00%

1990-1991 10 26.30% 28 73.70% 38 100.00%

1991-1992 6 17.60% 28 82.40% 34 100.00%

1992-1993 8 20.00% 32 80.00% 40 100.00%

1993-1994 6 14.30% 36 85.70% 42 100.00%

1994-1995 9 25.00% 27 75.00% 36 100.00%

1995-1996 6 18.80% 26 81.30% 32 100.00%

1996-1997 7 14.00% 43 86.00% 50 100.00%

1997-1998 6 12.00% 44 88.00% 50 100.00%

1998-1999 10 18.20% 45 81.80% 55 100.00%

1999-2000 9 20.50% 35 79.50% 44 100.00%

2000-2001 12 28.60% 30 71.40% 42 100.00%

2001-2002 5 9.60% 47 90.40% 52 100.00%

2002-2003 10 26.30% 28 73.70% 38 100.00%

2003-2004 12 22.20% 42 77.80% 54 100.00%

2004-2005 5 15.60% 27 84.40% 32 100.00%

2005-2006 7 21.90% 25 78.10% 32 100.00%

2006-2007 7 14.60% 41 85.40% 48 100.00%

2007-2008 9 17.00% 44 83.00% 53 100.00%

2008-2009 10 12.20% 72 87.80% 82 100.00%

2009-2010 16 27.60% 42 72.40% 58 100.00%

2010-2011 9 19.10% 38 80.90% 47 100.00%

2011-2012 8 15.40% 44 84.60% 52 100.00%

2012-2013 5 29.40% 12 70.60% 17 100.00%

2013-2014 2 6.50% 29 93.50% 31 100.00%

2014-2015 6 20.00% 24 80.00% 30 100.00%

2015-2016 14 23.70% 45 76.30% 59 100.00%

Total 293 18.95% 1253 81.05% 1546 100.00%

Total* 328 19.85% 1324 80.15% 1652 100.00%



Table 3: Number of Indirect catastrophic injuries/illnesses by year: All sports combined, all levels (high school and college)


N % N % N %

1982-1983 6 28.60% 15 71.40% 21 100.00%

1983-1984 5 25.00% 15 75.00% 20 100.00%

1984-1985 0 0 11 100.00% 11 100.00%

1985-1986 1 12.50% 7 87.50% 8 100.00%

1986-1987 4 22.20% 14 77.80% 18 100.00%

1987-1988 7 36.80% 12 63.20% 19 100.00%

1988-1989 4 23.50% 13 76.50% 17 100.00%

1989-1990 2 9.50% 19 90.50% 21 100.00%

1990-1991 4 17.40% 19 82.60% 23 100.00%

1991-1992 5 38.50% 8 61.50% 13 100.00%

1992-1993 2 9.50% 19 90.50% 21 100.00%

1993-1994 5 23.80% 16 76.20% 21 100.00%

1994-1995 3 23.10% 10 76.90% 13 100.00%

1995-1996 2 10.50% 17 89.50% 19 100.00%

1996-1997 2 12.50% 14 87.50% 16 100.00%

1997-1998 9 36.00% 16 64.00% 25 100.00%

1998-1999 0 0 23 100.00% 23 100.00%

1999-2000 0 0 26 100.00% 26 100.00%

2000-2001 5 18.50% 22 81.50% 27 100.00%

2001-2002 9 31.00% 20 69.00% 29 100.00%

2002-2003 6 25.00% 18 75.00% 24 100.00%

2003-2004 6 30.00% 14 70.00% 20 100.00%

2004-2005 4 12.10% 29 87.90% 33 100.00%

2005-2006 5 21.70% 18 78.30% 23 100.00%

2006-2007 6 23.10% 20 76.90% 26 100.00%

2007-2008 6 21.40% 22 78.60% 28 100.00%

2008-2009 7 26.90% 19 73.10% 26 100.00%

2009-2010 11 28.90% 27 71.10% 38 100.00%

2010-2011 6 23.10% 20 76.90% 26 100.00%

2011-2012 7 28.00% 18 72.00% 25 100.00%

2012-2013 7 30.40% 16 69.60% 23 100.00%

2013-2014 14 35.00% 26 65.00% 40 100.00%

2014-2015 11 22.00% 39 78.00% 50 100.00%

2015-2016 4 10.00% 36 90.00% 40 100.00%

Total 175 21.53% 638 78.47% 813 100.00%

Total* 175 21.24% 649 78.76% 824 100.00%



Table 4a: Number of Direct catastrophic injuries/illnesses by severity by sport: High school all years combined

Serious Non-fatal Fatal All

N % N % N % N %

Baseball Male 23 35.90% 26 40.60% 15 23.40% 64 100.00%

Basketball Female 3 50.00% 3 50.00% 0 0 6 100.00%

Male 8 53.30% 6 40.00% 1 6.70% 15 100.00%

Cheerleading Female 42 60.00% 27 38.60% 1 1.40% 70 100.00%

Male 1 50.00% 1 50.00% 0 0 2 100.00%

Cross Country Female 0 0 0 0 1 100.00% 1 100.00%

Male 0 0 1 50.00% 1 50.00% 2 100.00%

Field Hockey Female 0 0 3 100.00% 0 0 3 100.00%

Football Male 380 41.10% 412 44.50% 133 14.40% 925 100.00%

Golf Male 0 0 1 100.00% 0 0 1 100.00%

Gymnastics Female 3 30.00% 7 70.00% 0 0 10 100.00%

Male 1 25.00% 2 50.00% 1 25.00% 4 100.00%

Ice Hockey Female 2 66.70% 1 33.30% 0 0 3 100.00%

Male 7 26.90% 15 57.70% 4 15.40% 26 100.00%

Lacrosse Female 2 66.70% 1 33.30% 0 0 3 100.00%

Male 6 35.30% 9 52.90% 2 11.80% 17 100.00%

Skiing Female 0 0 0 0 1 100.00% 1 100.00%

Soccer Female 5 71.40% 1 14.30% 1 14.30% 7 100.00%

Male 6 37.50% 3 18.80% 7 43.80% 16 100.00%

Softball Female 6 85.70% 1 14.30% 0 0 7 100.00%

Swimming Female 1 16.70% 5 83.30% 0 0 6 100.00%

Male 3 30.00% 6 60.00% 1 10.00% 10 100.00%

Track and Field Female 6 66.70% 2 22.20% 1 11.10% 9 100.00%

Male 12 22.60% 20 37.70% 21 39.60% 53 100.00%

Wrestling Male 21 33.30% 40 63.50% 2 3.20% 63 100.00%


Table 4b: Number of Indirect catastrophic injuries/illnesses by severity by sport: High school all years combined


N % N % N % N %

Baseball Male 4 17.40% 0 0 19 82.60% 23 100.00%

Basketball Female 1 5.60% 0 0 17 94.40% 18 100.00%

Male 15 11.00% 1 0.70% 120 88.20% 136 100.00%


Cross Country Female 3 21.40% 1 7.10% 10 71.40% 14 100.00%

Male 2 8.70% 1 4.30% 20 87.00% 23 100.00%

Unknown 1 100.00% 0 0 0 0 1 100.00%

Drill Team Female 0 0 0 0 1 100.00% 1 100.00%

Field Hockey Female 0 0 0 0 2 100.00% 2 100.00%

Football Male 24 9.30% 2 0.80% 233 90.00% 259 100.00%

Ice Hockey Male 2 33.30% 0 0 4 66.70% 6 100.00%

Lacrosse Male 0 0 0 0 8 100.00% 8 100.00%

Rowing Male 1 100.00% 0 0 0 0 1 100.00%

Soccer Female 1 10.00% 1 10.00% 8 80.00% 10 100.00%

Male 3 9.40% 2 6.30% 27 84.40% 32 100.00%

Softball Female 0 0 0 0 1 100.00% 1 100.00%

Swimming Female 2 20.00% 1 10.00% 7 70.00% 10 100.00%

Male 0 0 0 0 5 100.00% 5 100.00%

Tennis Male 0 0 0 0 4 100.00% 4 100.00%

Track and Field Female 0 0 1 14.30% 6 85.70% 7 100.00%

Male 2 5.30% 0 0 36 94.70% 38 100.00%

Volleyball Female 1 33.30% 1 33.30% 1 33.30% 3 100.00%

Water Polo Female 0 0 0 0 1 100.00% 1 100.00%

Male 0 0 0 0 3 100.00% 3 100.00%

Wrestling Male 4 12.10% 1 3.00% 28 84.80% 33 100.00%


Table 5a: Number of Direct catastrophic injuries/illnesses by severity by sport: College all years combined


N % N % N % N %

Baseball Male 7 35.00% 10 50.00% 3 15.00% 20 100.00%

Basketball Male 8 80.00% 1 10.00% 1 10.00% 10 100.00%


Male 3 60.00% 2 40.00% 0 0 5 100.00%

Equestrian Female 0 0 0 0 1 100.00% 1 100.00%

Field Hockey Female 2 66.70% 1 33.30% 0 0 3 100.00%

Football Male 141 70.10% 47 23.40% 13 6.50% 201 100.00%

Gymnastics Female 0 0 2 100.00% 0 0 2 100.00%

Male 2 66.70% 1 33.30% 0 0 3 100.00%

Unknown 0 0 1 100.00% 0 0 1 100.00%

Ice Hockey Female 1 100.00% 0 0 0 0 1 100.00%

Male 7 58.30% 5 41.70% 0 0 12 100.00%

Lacrosse Female 0 0 2 100.00% 0 0 2 100.00%

Male 1 16.70% 1 16.70% 4 66.70% 6 100.00%

Rodeo Male 0 0 0 0 2 100.00% 2 100.00%

Rowing Male 0 0 0 0 1 100.00% 1 100.00%

Rugby Male 1 50.00% 1 50.00% 0 0 2 100.00%

Skiing Female 0 0 1 50.00% 1 50.00% 2 100.00%

Male 0 0 0 0 1 100.00% 1 100.00%

Soccer Female 0 0 2 100.00% 0 0 2 100.00%

Male 2 66.70% 1 33.30% 0 0 3 100.00%

Softball Female 2 100.00% 0 0 0 0 2 100.00%

Swimming Male 0 0 1 100.00% 0 0 1 100.00%

Track and Field Female 0 0 1 100.00% 0 0 1 100.00%

Male 2 14.30% 6 42.90% 6 42.90% 14 100.00%

Wrestling Male 0 0 2 100.00% 0 0 2 100.00%


Table 5b: Number of Indirect catastrophic injuries/illnesses by severity by sport: College all years combined


N % N % N % N %

Baseball Male 0 0 1 16.70% 5 83.30% 6 100.00%

Basketball Female 3 37.50% 0 0 5 62.50% 8 100.00%

Male 9 19.10% 3 6.40% 35 74.50% 47 100.00%

Cross Country Female 0 0 0 0 1 100.00% 1 100.00%

Male 0 0 0 0 2 100.00% 2 100.00%

Football Male 3 4.90% 0 0 58 95.10% 61 100.00%

Gymnastics Female 0 0 0 0 1 100.00% 1 100.00%

Ice Hockey Male 1 33.30% 1 33.30% 1 33.30% 3 100.00%

Lacrosse Male 0 0 0 0 2 100.00% 2 100.00%

Rowing Male 0 0 0 0 2 100.00% 2 100.00%

Skiing Male 0 0 0 0 1 100.00% 1 100.00%

Soccer Female 1 25.00% 0 0 3 75.00% 4 100.00%

Male 0 0 2 25.00% 6 75.00% 8 100.00%

Swimming Female 1 33.30% 0 0 2 66.70% 3 100.00%

Male 0 0 0 0 7 100.00% 7 100.00%

Tennis Female 0 0 0 0 1 100.00% 1 100.00%

Male 0 0 0 0 1 100.00% 1 100.00%

Track and Field Male 1 33.30% 0 0 2 66.70% 3 100.00%

Volleyball Female 3 60.00% 0 0 2 40.00% 5 100.00%

Water Polo Male 0 0 0 0 2 100.00% 2 100.00%

Wrestling Male 2 28.60% 0 0 5 71.40% 7 100.00%


Table 6a: Number of Catastrophic injuries/illnesses by Severity by year: High school

Fatal Non-fatal Serious

N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

1982-1983 25 0.49 10 0.20 15 0.30

1983-1984 23 0.46 15 0.30 11 0.22

1984-1985 17 0.34 13 0.26 12 0.24

1985-1986 10 0.20 15 0.29 16 0.31

1986-1987 26 0.51 14 0.27 12 0.23

1987-1988 17 0.33 25 0.48 27 0.52

1988-1989 21 0.40 19 0.37 17 0.33

1989-1990 24 0.46 26 0.50 15 0.29

1990-1991 23 0.44 15 0.29 9 0.17

1991-1992 12 0.23 9 0.17 15 0.28

1992-1993 23 0.43 14 0.26 14 0.26

1993-1994 21 0.38 16 0.29 15 0.27

1994-1995 12 0.21 13 0.23 12 0.21

1995-1996 19 0.32 16 0.27 8 0.13

1996-1997 24 0.40 20 0.33 13 0.21

1997-1998 24 0.38 24 0.38 12 0.19

1998-1999 31 0.48 14 0.22 23 0.36

1999-2000 33 0.51 17 0.26 11 0.17

2000-2001 26 0.39 16 0.24 10 0.15

2001-2002 28 0.43 22 0.34 17 0.26

2002-2003 21 0.31 13 0.19 12 0.18

2003-2004 17 0.25 24 0.36 15 0.22

2004-2005 33 0.48 17 0.25 6 0.09

2005-2006 20 0.29 15 0.21 8 0.11

2006-2007 21 0.29 24 0.34 16 0.22

2007-2008 23 0.32 16 0.22 27 0.37

2008-2009 28 0.38 32 0.44 31 0.42

2009-2010 24 0.32 19 0.26 26 0.35

2010-2011 22 0.30 18 0.24 18 0.24

2011-2012 22 0.30 23 0.31 17 0.23

2012-2013 16 0.21 7 0.09 5 0.07

2013-2014 19 0.26 10 0.14 26 0.36

2014-2015 22 0.29 11 0.15 29 0.38

2015-2016 25 0.33 15 0.20 41 0.54

Note: Rates with number of incidents less than 5 should be interpreted with caution.


Table 6b: Number of Catastrophic injuries/illnesses by Severity by year: College


N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

1982-1983 6 2.34 3 1.17 1 0.39

1983-1984 5 1.85 2 0.74 6 2.22

1984-1985 1 0.35 3 1.04 5 1.73

1985-1986 4 1.38 4 1.38 8 2.75

1986-1987 5 1.80 2 0.72 11 3.96

1987-1988 7 2.64 1 0.38 7 2.64

1988-1989 4 1.49 4 1.49 9 3.34

1989-1990 3 1.14 2 0.76 5 1.89

1990-1991 5 1.82 6 2.18 3 1.09

1991-1992 5 1.78 2 0.71 4 1.43

1992-1993 3 1.05 0 0 7 2.46

1993-1994 7 2.39 0 0 4 1.37

1994-1995 3 1.01 3 1.01 6 2.02

1995-1996 2 0.60 4 1.19 2 0.60

1996-1997 3 0.91 5 1.51 1 0.30

1997-1998 9 2.68 2 0.59 4 1.19

1998-1999 2 0.56 3 0.84 5 1.40

1999-2000 2 0.56 2 0.56 5 1.40

2000-2001 7 1.89 5 1.35 5 1.35

2001-2002 10 2.74 1 0.27 3 0.82

2002-2003 6 1.60 4 1.07 6 1.60

2003-2004 9 2.39 4 1.06 5 1.33

2004-2005 4 1.04 3 0.78 2 0.52

2005-2006 5 1.27 5 1.27 2 0.51

2006-2007 6 1.48 1 0.25 6 1.48

2007-2008 5 1.21 2 0.48 8 1.93

2008-2009 5 1.18 2 0.47 10 2.37

2009-2010 13 3.01 2 0.46 12 2.78

2010-2011 4 0.90 8 1.80 3 0.67

2011-2012 7 1.54 0 0 8 1.76

2012-2013 6 1.29 3 0.65 3 0.65

2013-2014 6 1.26 0 0 10 2.11

2014-2015 4 0.83 1 0.21 12 2.48

2015-2016 2 0.41 4 0.82 12 2.46



Table 7a: Rate of direct catastrophic injuries/illnesses by severity by year: High school


N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

1982-1983 10 0.20 10 0.20 15 0.30

1983-1984 8 0.16 15 0.30 11 0.22

1984-1985 6 0.12 13 0.26 12 0.24

1985-1986 3 0.06 15 0.29 16 0.31

1986-1987 13 0.25 14 0.27 11 0.21

1987-1988 5 0.10 25 0.48 27 0.52

1988-1989 8 0.15 19 0.37 17 0.33

1989-1990 5 0.10 26 0.5 15 0.29

1990-1991 4 0.08 15 0.29 9 0.17

1991-1992 4 0.08 9 0.17 15 0.28

1992-1993 4 0.08 14 0.26 14 0.26

1993-1994 5 0.09 16 0.29 15 0.27

1994-1995 2 0.04 13 0.23 12 0.21

1995-1996 4 0.07 15 0.25 7 0.12

1996-1997 10 0.16 20 0.33 13 0.21

1997-1998 8 0.13 24 0.38 12 0.19

1998-1999 8 0.13 14 0.22 23 0.36

1999-2000 7 0.11 17 0.26 11 0.17

2000-2001 4 0.06 16 0.24 10 0.15

2001-2002 9 0.14 21 0.32 17 0.26

2002-2003 3 0.04 13 0.19 12 0.18

2003-2004 3 0.04 24 0.36 15 0.22

2004-2005 5 0.07 16 0.23 6 0.09

2005-2006 4 0.06 14 0.20 7 0.10

2006-2007 2 0.03 23 0.32 16 0.22

2007-2008 2 0.03 16 0.22 26 0.36

2008-2009 10 0.14 31 0.42 31 0.42

2009-2010 2 0.03 18 0.24 22 0.30

2010-2011 5 0.07 17 0.23 16 0.22

2011-2012 4 0.05 23 0.31 17 0.23

2012-2013 3 0.04 5 0.07 4 0.05

2013-2014 8 0.11 9 0.12 12 0.16

2014-2015 6 0.08 10 0.13 7 0.09

2015-2016 8 0.11 15 0.20 22 0.29



Table 7b: Rate of direct catastrophic injuries/illnesses by severity by year: College


N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

1982-1983 0 0 3 1.17 1 0.39

1983-1984 0 0 2 0.74 6 2.22

1984-1985 1 0.35 3 1.04 5 1.73

1985-1986 3 1.03 4 1.38 8 2.75

1986-1987 1 0.36 2 0.72 11 3.96

1987-1988 0 0 1 0.38 7 2.64

1988-1989 0 0 4 1.49 9 3.34

1989-1990 1 0.38 2 0.76 5 1.89

1990-1991 1 0.36 6 2.18 3 1.09

1991-1992 1 0.36 1 0.36 4 1.43

1992-1993 1 0.35 0 0 7 2.46

1993-1994 2 0.68 0 0 4 1.37

1994-1995 0 0 3 1.01 6 2.02

1995-1996 0 0 4 1.19 2 0.60

1996-1997 1 0.30 5 1.51 1 0.30

1997-1998 1 0.30 1 0.30 4 1.19

1998-1999 2 0.56 3 0.84 5 1.40

1999-2000 2 0.56 2 0.56 5 1.40

2000-2001 2 0.54 5 1.35 5 1.35

2001-2002 1 0.27 1 0.27 3 0.82

2002-2003 1 0.27 3 0.80 6 1.60

2003-2004 3 0.80 4 1.06 5 1.33

2004-2005 1 0.26 2 0.52 2 0.52

2005-2006 0 0 5 1.27 2 0.51

2006-2007 0 0 1 0.25 6 1.48

2007-2008 0 0 1 0.24 8 1.93

2008-2009 0 0 1 0.24 9 2.13

2009-2010 4 0.93 2 0.46 10 2.32

2010-2011 0 0 7 1.57 2 0.45

2011-2012 1 0.22 0 0 7 1.54

2012-2013 0 0 3 0.65 2 0.43

2013-2014 1 0.21 0 0 1 0.21

2014-2015 0 0 1 0.21 5 1.03

2015-2016 0 0 4 0.82 10 2.05



Table 8a: Rate of indirect catastrophic injuries/illnesses by severity by year: High School


N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

1982-1983 15 0.30 0 0 0 0

1983-1984 15 0.30 0 0 0 0

1984-1985 11 0.22 0 0 0 0

1985-1986 7 0.14 0 0 0 0

1986-1987 13 0.25 0 0 1 0.02

1987-1988 12 0.23 0 0 0 0

1988-1989 13 0.25 0 0 0 0

1989-1990 19 0.37 0 0 0 0

1990-1991 19 0.36 0 0 0 0

1991-1992 8 0.15 0 0 0 0

1992-1993 19 0.36 0 0 0 0

1993-1994 16 0.29 0 0 0 0

1994-1995 10 0.18 0 0 0 0

1995-1996 15 0.25 1 0.02 1 0.02

1996-1997 14 0.23 0 0 0 0

1997-1998 16 0.26 0 0 0 0

1998-1999 23 0.36 0 0 0 0

1999-2000 26 0.40 0 0 0 0

2000-2001 22 0.33 0 0 0 0

2001-2002 19 0.29 1 0.02 0 0

2002-2003 18 0.27 0 0 0 0

2003-2004 14 0.21 0 0 0 0

2004-2005 28 0.41 1 0.01 0 0

2005-2006 16 0.23 1 0.01 1 0.01

2006-2007 19 0.27 1 0.01 0 0

2007-2008 21 0.29 0 0 1 0.01

2008-2009 18 0.25 1 0.01 0 0

2009-2010 22 0.30 1 0.01 4 0.05

2010-2011 17 0.23 1 0.01 2 0.03

2011-2012 18 0.24 0 0 0 0

2012-2013 13 0.17 2 0.03 1 0.01

2013-2014 11 0.15 1 0.01 14 0.19

2014-2015 16 0.21 1 0.01 22 0.29

2015-2016 17 0.22 0 0 19 0.25



Table 8b: Rate of indirect catastrophic injuries/illnesses by severity by year: College


N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

1982-1983 6 2.34 0 0 0 0

1983-1984 5 1.85 0 0 0 0

1985-1986 1 0.34 0 0 0 0

1986-1987 4 1.44 0 0 0 0

1987-1988 7 2.64 0 0 0 0

1988-1989 4 1.49 0 0 0 0

1989-1990 2 0.76 0 0 0 0

1990-1991 4 1.45 0 0 0 0

1991-1992 4 1.43 1 0.36 0 0

1992-1993 2 0.70 0 0 0 0

1993-1994 5 1.71 0 0 0 0

1994-1995 3 1.01 0 0 0 0

1995-1996 2 0.60 0 0 0 0

1996-1997 2 0.60 0 0 0 0

1997-1998 8 2.38 1 0.30 0 0

2000-2001 5 1.35 0 0 0 0

2001-2002 9 2.47 0 0 0 0

2002-2003 5 1.34 1 0.27 0 0

2003-2004 6 1.59 0 0 0 0

2004-2005 3 0.78 1 0.26 0 0

2005-2006 5 1.27 0 0 0 0

2006-2007 6 1.48 0 0 0 0

2007-2008 5 1.21 1 0.24 0 0

2008-2009 5 1.18 1 0.24 1 0.24

2009-2010 9 2.08 0 0 2 0.46

2010-2011 4 0.90 1 0.22 1 0.22

2011-2012 6 1.32 0 0 1 0.22

2012-2013 6 1.29 0 0 1 0.22

2013-2014 5 1.05 0 0 9 1.90

2014-2015 4 0.83 0 0 7 1.45

2015-2016 2 0.41 0 0 2 0.41



Table 9a: Rate of Direct catastrophic injuries/illnesses by level and severity by sport: High school


N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

Baseball Male 15 0.10 26 0.17 23 0.15

Basketball Female 0 0 3 0.02 3 0.02

Male 1 0.01 6 0.03 8 0.04

Cheerleading Female 1 0.05 27 1.33 42 2.07

Male 0 0 1 1.92 1 1.92

Cross Country Female 1 0.02 0 0 0 0

Male 1 0.02 1 0.02 0 0

Field Hockey Female 0 0 3 0.16 0 0

Football Male 133 0.39 412 1.21 380 1.12

Golf Male 0 0 1 0.02 0 0

Gymnastics Female 0 0 7 0.89 3 0.38

Male 1 0.86 2 1.73 1 0.86

Ice Hockey Female 0 0 1 0.69 2 1.38

Male 4 0.4 15 1.48 7 0.69

Lacrosse Female 0 0 1 0.08 2 0.17

Male 2 0.12 9 0.54 6 0.36

Skiing Female 1 0.35 0 0 0 0

Soccer Female 1 0.01 1 0.01 5 0.06

Male 7 0.07 3 0.03 6 0.06

Softball Female 0 0 1 0.01 6 0.05

Swimming Female 0 0 5 0.12 1 0.02

Male 1 0.03 6 0.18 3 0.09

Track and Field Female 1 0.01 2 0.01 6 0.04

Male 21 0.11 20 0.11 12 0.06

Wrestling Male 2 0.02 40 0.48 21 0.25



Table 9b: Rate of Direct catastrophic injuries/illnesses by level and severity by sport: College


N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

Baseball Male 3 0.34 10 1.14 7 0.80

Basketball Male 1 0.19 1 0.19 8 1.54

Equestrian Female 1 4.33 0 0 0 0

Field Hockey Female 0 0 1 0.55 2 1.09

Football Male 13 0.66 47 2.40 141 7.20

Gymnastics Female 0 0 2 3.94 0 0

Male 0 0 1 5.57 2 11.13

Ice Hockey Female 0 0 0 0 1 2.88

Male 0 0 5 3.78 7 5.30

Lacrosse Female 0 0 2 1.11 0 0

Male 4 1.63 1 0.41 1 0.41

Rowing Male 1 1.37 0 0 0 0

Skiing Female 1 5.86 1 5.86 0 0

Male 1 4.81 0 0 0 0

Soccer Female 0 0 2 0.38 0 0

Male 0 0 1 0.16 2 0.32

Softball Female 0 0 0 0 2 0.42

Swimming Male 0 0 1 0.36 0 0

Track and Field

Female 0 0 1 0.09 0 0

Male 6 0.45 6 0.45 2 0.15

Wrestling Male 0 0 2 0.87 0 0



Table 10a: Indirect catastrophic events by level and severity: High school


N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

Baseball Male 19 0.13 0 0 4 0.03

Basketball Female 17 0.12 0 0 1 0.01

Male 120 0.66 1 0.01 15 0.08

Cheerleading Female 8 0.39 1 0.05 1 0.05

Cross Country

Female 10 0.19 1 0.02 3 0.06

Male 20 0.33 1 0.02 2 0.03

Field Hockey Female 2 0.10 0 0 0 0

Football Male 233 0.68 2 0.01 24 0.07

Ice Hockey Male 4 0.40 0 0 2 0.20

Lacrosse Male 8 0.48 0 0 0 0

Rowing Male 0 0 0 0 1 1.97

Soccer Female 8 0.10 1 0.01 1 0.01

Male 27 0.26 2 0.02 3 0.03

Softball Female 1 0.01 0 0 0 0

Swimming Female 7 0.17 1 0.02 2 0.05

Male 5 0.15 0 0 0 0

Tennis Male 4 0.08 0 0 0 0

Track and Field

Female 6 0.04 1 0.01 0 0

Male 36 0.19 0 0 2 0.01

Volleyball Female 1 0.01 1 0.01 1 0.01

Water Polo Female 1 0.29 0 0 0 0

Male 3 0.62 0 0 0 0

Wrestling Male 28 0.33 1 0.01 4 0.05



Table 10b: Indirect catastrophic events by level and severity: College


N Rate per 100,000

N Rate per 100,000

N Rate per 100,000

Baseball Male 5 0.57 1 0.11 0 0

Basketball Female 5 1.09 0 0 3 0.65

Male 35 6.74 3 0.58 9 1.73

Cross Country

Female 1 0.27 0 0 0 0

Male 2 0.52 0 0 0 0

Football Male 58 2.96 0 0 3 0.15

Gymnastics Female 1 1.97 0 0 0 0

Ice Hockey Male 1 0.76 1 0.76 1 0.76

Lacrosse Male 2 0.81 0 0 0 0

Rowing Male 2 2.73 0 0 0 0

Skiing Male 1 4.81 0 0 0 0

Soccer Female 3 0.57 0 0 1 0.19

Male 6 0.97 2 0.32 0 0

Swimming Female 2 0.60 0 0 1 0.30

Male 7 2.53 0 0 0 0

Tennis Female 1 0.36 0 0 0 0

Male 1 0.38 0 0 0 0

Track and Field

Male 2 0.15 0 0 1 0.07

Volleyball Female 2 0.47 0 0 3 0.70

Water Polo Male 2 5.97 0 0 0 0

Wrestling Male 5 2.16 0 0 2 0.87



Table 11: Characteristics of all sport-related catastrophic events during AY 2015-2016

Direct Indirect All

N % N % N %

Total 61 100.00% 40 100.00% 101 100.00%

Level

15 24.60% 4 10.00% 19 18.80% College

High school 46 75.40% 36 90.00% 82 81.20%

Severity

33 54.10% 21 52.50% 54 53.50% Serious

Non-fatal 19 31.10% 0 0 19 18.80%

Fatal 9 14.80% 19 47.50% 28 27.70%

Sex

3 4.90% 9 22.50% 12 11.90% Female

Male 58 95.10% 31 77.50% 89 88.10%

Month

4 6.60% 13 32.50% 17 16.80% Jul-Aug

Sep-Oct 42 68.90% 7 17.50% 49 48.50%

Nov-Dec 4 6.60% 5 12.50% 9 8.90%

Jan-Feb 1 1.60% 6 15.00% 7 6.90%

Mar-Apr 1 1.60% 3 7.50% 4 4.00%

May-Jun 9 14.80% 6 15.00% 15 14.90%

Sponsored activity

61 100.00% 36 90.00% 97 96.00% Official school or team athletic activity

Personal athletic activity 0 0 4 10.00% 4 4.00%

Type of Activity

49 80.30% 11 27.50% 60 59.40% Competition/Game

Practice 9 14.80% 21 52.50% 30 29.70%

Scrimmage 2 3.30% 0 0 2 2.00%

Strength/Weight Session 0 0 1 2.50% 1 1.00%

Conditioning Session 1 1.60% 4 10.00% 5 5.00%

Other 0 0 3 7.50% 3 3.00%

Location

51 83.60% 14 35.00% 65 64.40% Competitive Venue

Public Park or Street 1 1.60% 3 7.50% 4 4.00%

School Athletic Facility 9 14.80% 21 52.50% 30 29.70%

School Campus 0 0 2 5.00% 2 2.00%

Type of injury

4 6.60% 0 0 4 4.00% Bleed/hemorrhage

Cardiac arrest 0 0 12 30.00% 12 11.90%

Cardiac arrhythmia 0 0 1 2.50% 1 1.00%

Cardiomyopathy 0 0 4 10.00% 4 4.00%

Commotio cordis 3 4.90% 0 0 3 3.00%

Congenital heart 0 0 7 17.50% 7 6.90%

Contusion 1 1.60% 0 0 1 1.00%


Direct Indirect All

N % N % N %

Fracture 25 41.00% 0 0 25 24.80%

Heat stroke 0 0 7 17.50% 7 6.90%

Other 0 0 3 7.50% 3 3.00%

Other trauma 10 16.40% 0 0 10 9.90%

Rhabdomyolysis 0 0 2 5.00% 2 2.00%

Spinal cord 2 3.30% 0 0 2 2.00%

Stroke 1 1.60% 0 0 1 1.00%

Subdural hematoma 2 3.30% 0 0 2 2.00%

Traumatic brain injury, NS 10 16.40% 0 0 10 9.90%

Unknown 3 4.90% 4 10.00% 7 6.90%

Body part

19 31.10% 2 5.00% 21 20.80% Head/brain

Neck 31 50.80% 0 0 31 30.70%

Heart 3 4.90% 28 70.00% 31 30.70%

Total body 1 1.60% 9 22.50% 10 9.90%

Unknown 0 0 1 2.50% 1 1.00%

Eye 3 4.90% 0 0 3 3.00%

Internal organ 1 1.60% 0 0 1 1.00%

Lumbar/thoracic spine 3 4.90% 0 0 3 3.00%

Sport

2 3.30% 2 5.00% 4 4.00% Baseball

Basketball 0 0 6 15.00% 6 5.90%

Cheerleading 1 1.60% 0 0 1 1.00%

Cross Country 1 1.60% 2 5.00% 3 3.00%

Field Hockey 0 0 1 2.50% 1 1.00%

Football 51 83.60% 14 35.00% 65 64.40%

Gymnastics 1 1.60% 0 0 1 1.00%

Ice Hockey 0 0 1 2.50% 1 1.00%

Lacrosse 1 1.60% 0 0 1 1.00%

Rodeo 1 1.60% 0 0 1 1.00%

Soccer 0 0 5 12.50% 5 5.00%

Swimming 1 1.60% 3 7.50% 4 4.00%

Track and Field 2 3.30% 3 7.50% 5 5.00%

Volleyball 0 0 2 5.00% 2 2.00%

Wrestling 0 0 1 2.50% 1 1.00%

NS=not specified


Table 12. Participation numbers, 1982-1983 to 2015-2016

High School1 College2 Female Male Female Male

Baseball 31,866 15,165,297 -- 879,630

Basketball 14,529,374 18,133,578 458,735 519,365

Cheerleading 2,031,731 52,067 -- --

Cross Country 5,183,876 6,122,693 375,179 383,292

Equestrian 20,511 3,522 23,076 1,038

Field Hockey 1,926,416 4,660 182,766 --

Football 29,779 34,032,843 -- 1,957,783

Golf 1,757,757 4,878,818 99,342 259,660

Gymnastics 788,222 115,631 50,763 17,964

Ice Hockey 144,484 1,010,693 34,684 132,192

Lacrosse 1,203,237 1,661,042 180,865 245,893

Rowing 59,213 50,745 158,166 73,249

Skiing 282,792 340,914 17,069 20,802

Soccer 8,134,942 10,470,106 530,865 617,201

Softball 11,177,148 51,832 474,586 --

Swimming 4,226,123 3,376,275 332,070 276,842

Tennis 5,231,332 4,893,848 275,754 264,124

Track and Field 15,046,743 18,471,725 1,144,140 1,342,408

Volleyball 12,200,749 1,124,092 428,126 38,350

Water Polo 340,759 481,277 21,417 33,475

Wrestling 117,816 8,358,938 -- 231,164

1NFHS available online: https://www.nfhs.org/ParticipationStatistics/ParticipationStatistics/ 2NCAA accessed online: https://www.ncaapublications.com/p-4445-2015-16-ncaa-sports-sponsorship-and-

participation-rates-report.aspx

Note: Not all high schools and colleges are members of the NFHS and NCAA. Complete data is

not available for the non-member schools. Therefore, these participation numbers underestimate

the total number of high school and collegiate participants in the United States.


Figure 1: Rates of fatal catastrophic direct and indirect injuries/illnesses by sport-gender among

high school participants, 1982/83-2015/16



Figure 2: Rates of all catastrophic direct and indirect injuries/illnesses by sport-gender among

high school participants, 1982/83-2015/16



Figure 3: Rates of fatal catastrophic direct and indirect injuries/illnesses by sport-gender among

collegiate participants, 1982/83-2015/16



Figure 4: Rates of all catastrophic direct and indirect injuries/illnesses by sport-gender among

collegiate participants, 1982/83-2015/16


Documents

CATASTROPHIC SPORTS INJURY RESEARCH THIRTY-FOURTH ANNUAL …€¦ · 05/10/2017 · THIRTY-FOURTH ANNUAL REPORT FALL 1982 - SPRING 2016 From the National Center for Catastrophic